caa a22 4500 445332867 CHVBK 20180317142743.0 cr unu---uuuuu 170323e20110101xx s 000 0 eng 10.1245/s10434-010-1243-5 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1243-5 Hemorrhagic Pituitary Macroadenoma: Characteristics, Endoscopic Endonasal Transsphenoidal Surgery, and Outcomes [Elektronische Daten] [Xiang Zhang, Wei Zhang, Luo-an Fu, Jin-xiang Cheng, Bo-lin Liu, Wei-dong Cao, Zhou Fei, Jian-ning Zhang, Wei-ping Liu, Hai-ning Zhen] Purpose: This study aims to assess the effect of endoscopic endonasal transsphenoidal surgery (EETSS) of hemorrhagic pituitary macroadenoma (HPMA). Patients and Methods: We retrospectively reviewed 52 cases with HPMA collected from the Xijing Hospital from April 1995 to April 2009. There were 39 males and 13 females, ranging in age from 18 to 79years (average 51.6years). Patients presented with headache or acute ophthalmological symptoms after adenoma hemorrhage. Computed tomography (CT) scan and magnetic resonance imaging (MRI) showed pituitary macroadenoma with hemorrhage in all cases. Twenty-eight adenomas showed marked suprasellar extension, 19 showed moderate extension, and another 5 showed slight extension. All patients were promptly treated by emergency EETSS, usually within 24h after hospitalization. Results: Total removal of tumor was achieved in 46 cases (88.5%), and subtotal removal in 6 cases (11.5%). Postoperative radiotherapy and reoperation of the tumor were required in five patients with either residual or relapsed tumors. Follow-up ranged from 8 to 93months (mean 41.6months) for 43 cases. Visual acuity and visual field recovery and improvement was recorded in 92.1% and 94.3% of patients who had preoperative visual symptoms, respectively. Conclusions: The majority of macroadenomas are hemorrhagic, and they often occur in middle-aged, male subjects. Detection by imaging in the setting of pituitary apoplexy accurately predicts the nature of the apoplectic process and helps to guide the type and timing of surgery. Early EETSS is the most effective therapy and significantly improves visual outcomes and systemic conditions. Society of Surgical Oncology, 2010 Zhang Xiang Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China aut Zhang Wei Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China aut Fu Luo-an Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China aut Cheng Jin-xiang Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China aut Liu Bo-lin Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China aut Cao Wei-dong Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China aut Fei Zhou Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China aut Zhang Jian-ning Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China aut Liu Wei-ping Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China aut Zhen Hai-ning Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China aut Annals of Surgical Oncology Springer-Verlag 18/1(2011-01-01), 246-252 1068-9265 18:1<246 2011 18 10434 https://doi.org/10.1245/s10434-010-1243-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1243-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Zhang Xiang Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China aut NATIONALLICENCE 700 1- Zhang Wei Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China aut NATIONALLICENCE 700 1- Fu Luo-an Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China aut NATIONALLICENCE 700 1- Cheng Jin-xiang Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China aut NATIONALLICENCE 700 1- Liu Bo-lin Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China aut NATIONALLICENCE 700 1- Cao Wei-dong Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China aut NATIONALLICENCE 700 1- Fei Zhou Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China aut NATIONALLICENCE 700 1- Zhang Jian-ning Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China aut NATIONALLICENCE 700 1- Liu Wei-ping Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China aut NATIONALLICENCE 700 1- Zhen Hai-ning Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/1(2011-01-01), 246-252 1068-9265 18:1<246 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer